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HENT > Head & Neck Cancer (Dr. Mao) > Flashcards

Head & Neck Cancer (Dr. Mao) Flashcards

1
Q

Potential Skin and Mucosal sites for head/neck cancer

A

-nose cavity -paranasal sinuses -oral cavity -pharynx -larynx -thyroid glands -salivary glands

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2
Q

essentials of H&N cancer for PAs

A

-early diagnosis!!! (recognizing tumors) -pt. support -post-treatment surveillance (recognize tumor recurrence) -modifying causative patient behaviors (tumor prevention)

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3
Q

second most common skin cancer

A

squamous cell carcinoma

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4
Q

most common skin cancer

A

basal cell carcinoma

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5
Q

how does basal cell carcinoma spread?

A

spreads by local invasion (gets bigger and bigger), but does not tend to metastasize to distant sites

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6
Q

characteristics of BCC (how it looks)

A

-open sores -pearly! shiny bumps -red patch/pink growth -raised

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7
Q

SCC presentation (how it looks)

A

-tend to be ulcerated -scaly -elevated growths with central depressions

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8
Q

Where does malignant melanoma originate?

A

melanocytes

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9
Q

Important acronym for diagnosis of malignant melanoma

A

Assymetric Border irregularity Color variation/multiple Diameter >6mm Enlarging, evolving

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10
Q

Types/names of malignant melanoma

A

-superficial spreading -lentigo melanoma -acral lentiginous -nodular

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11
Q

staging melanoma is based on

A

depth of invasion -clark’s levels or Breslow’s

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12
Q

Risk factors of skin cancer

A

-sun exposure -# moles -fam hx -immunocompromised (like kaposi’s sarcoma, etc) -precancerous lesions like actinic keratosis or dysplastic nevi

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13
Q

Presenting signs of cancer

A

-non-healing ulcer -enlarging mass, neck mass -pain -hoarseness, dysphagia -anosmia, nasal obstruction, serous otitis, cranial neuropathies, otalgia

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14
Q

risk factors of cancer

A

-tobacco & alcohol -viral (HPV, EBV) -immune suppression -nutritional deficiencies -occupational exposure like woodworking -gastroesophageal reflux

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15
Q

How much greater is risk of H&N cancer in smokers with nonsmokers

A

5-35x greater in smokers

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16
Q

___% of patients with H&N cancer smoke tobacco

A

85-90%

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17
Q

Alcohol increases risk of cancer by how much

A

2-15x

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18
Q

_________ are synergistic carcinogens

A

alcohol and tobacco

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19
Q

Potentially premalignant lesions in the head and neck

A

-leukoplakia -erythroplakia -actinic keratoses of skin -squamous carcinoma in situ -dysplasia -verrucous hyperplasia

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20
Q

T in TNM staging system

A

T (0-4)

-size or characteristics of primary tumor

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21
Q

N in TNM staging system

A

N (0-3)

-size & location of cervical lymph node metastases

22
Q

M in TNM staging system

A

M (0-1)

-distant metastases

23
Q
A

SCC of tongue

24
Q
A

SCC of maxillary alveolar ridge

25
Q
A

SCC of lip

26
Q
A

SCC of Lip

27
Q
A

SCC floor of mouth

28
Q
A

SCC of buccal mucosa

29
Q
A

Leukoplakia

30
Q
A

actinic keratosis (precancer)

31
Q
A

Kaposi’s sarcoma

32
Q
A

mucosal melanoma

33
Q

presentation of salivary gland malignancies

A
  • present as gradually enlarging, painless mass
  • facial nerve weakness
34
Q

risk factors of savilary gland malignancy

A

risk factors: radiation

35
Q

sx/presentation of thyroid gland malignancies

A
  • painless enlarging mass
  • compressive sx
  • hoarseness
36
Q

risk factors for thyroid gland malignancy

A
  • prior radiation
  • fam hx
  • iodine deficiency
37
Q

work up for h&n cancers

A

thorough h&p

  • fiberoptic exam of pharynx & larynx
  • imaging- CT WITH contrast, U/S, PET-CT
  • needle aspiration/ biopsy
  • staging endoscopy anf further biopsy
38
Q

treatment options for H&N cancers

A
  • surgical excision
  • radiation therapy
  • chemo
  • radioactive iodine
  • combinations
39
Q

What does neck dissection control/ why would you do neck dissection in H&N cancers?

A
  • control lymph node metastasis
  • surgical removal of lymph nodes
40
Q

Reconstructive options for H&N cancer

A
  • primary closure
  • flaps
  • skin grafting
  • bone grafting
41
Q

How is radiation therapy typically given for H&N cancer

A

typically given as photon (cobalt) radiation

42
Q

Complications of radiation therapy for H&N cancer

A
  • dry mouth (xerostomia), increased dental & periodontal disease), osteoradionecrosis-mandibular bone
43
Q

typical treatment regimen for radiation therapy for H&N cancer

A
  • 200cGy fractions
  • once per day
  • five days per week
  • 6-7 weeks
44
Q

Typical agents of chemotherapy for H&N cancers

A

-cisPlatinum, 5-Fluorouracil (5FU), methotrexate

45
Q

complications of chemo for H&N cancers

A

-include mucositis, nausea, vomiting, hearing loss, decreased immunity

46
Q

Treatment of well-differentiated thyroid cancer

A
  • total thyroidectomy
  • ablative dose of radiactive iodid (4-6 weeks later)
47
Q

tx of Medullary carcinoma (thyroid cancer)

A
  • doesn’t resond to I-131
  • occasionally radiated
48
Q

tx of undifferentiated carcinoma (thyroid cancer)

A

-carries poor prognosis regardless of tx

49
Q

Notes on prognosis in H&N cancers

A
  • generally higher stage = poorer prognosis
  • 5 yrs tumor free, generally means cured for SCC
  • pt’s MUST stop smoking for a chance at good prognosis
50
Q
A

HENT (7 decks)

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